title: Cerebral microembolism during coronary angiography: a randomized comparison between femoral and radial arterial access.
abstract: OBJECTIVE
  Microemboli observed during coronary angiography can cause silent ischemic cerebral lesions. The aim of this study was to investigate if the number of particulate cerebral microemboli during coronary angiography is influenced by access site used.
  
  
  METHODS
  Fifty-one patients with stable angina pectoris referred for coronary angiography were randomized to right radial or right femoral arterial access. The number of particulate microemboli passing the middle cerebral arteries was continuously registered with transcranial Doppler.
  
  
  RESULTS
  The median (minimum-maximum range) numbers of particulate emboli were significantly higher with radial 10 (1-120) than with femoral 6 (1-19) access. More particulate microemboli passed the right middle cerebral artery with the radial access.
  
  
  CONCLUSIONS
  This study indicates that the radial access used for coronary angiography generates more particulate cerebral microemboli than the femoral access and thus may influence the occurrence of silent cerebral injuries.
authors.affiliation: Cardiology Unit, Department of Medicine, Karolinska University Hospital, Solna, N3:05, SE 171 76 Stockholm, Sweden. juliane.jurga@karolinska.se
authors.forename: Juliane
authors.initials: J
authors.lastname: Jurga
authors.forename: Jesper
authors.initials: J
authors.lastname: Nyman
authors.forename: Per
authors.initials: P
authors.lastname: Tornvall
authors.forename: Maria Nastase
authors.initials: MN
authors.lastname: Mannila
authors.forename: Peter
authors.initials: P
authors.lastname: Svenarud
authors.forename: Jan
authors.initials: J
authors.lastname: van der Linden
authors.forename: Nondita
authors.initials: N
authors.lastname: Sarkar
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging; D017023:Coronary Angiography / Q000009:adverse effects*; D005260:Female; D005263:Femoral Artery; D006801:Humans; D020766:Intracranial Embolism / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D017534:Radial Artery; D012189:Retrospective Studies; D012307:Risk Factors